RT Book, Section
A1 Hope, Aluko A.
A2 Oropello, John M.
A2 Pastores, Stephen M.
A2 Kvetan, Vladimir
SR Print(0)
ID 1136418770
T1 Ethics and Palliative Care in the Intensive Care Unit
T2 Critical Care
YR 1
FD 1
PB McGraw-Hill Education
PP New York, NY
SN 9780071820813
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1136418770
RD 2024/04/23
AB KEY  POINTSThe  four  principles  of  biomedical  ethics—beneficence,  nonmaleficence,  autonomy,  and  justice  can  provide  a  rubric  through  which  clinicians  can  identify  ethical  dilemmas  in  clinical  practice.Informed  consent  is  a  process  of  mutual  respect  between  a  clinician  and  a  patient  that  involves  (a)  ensuring  that  the  patient  has  the  capacity  to  make  the  specific  medical  decision;  (b)  the  skillful  disclosure  of  relevant  information  to  the  patient;  and  (c)  ensuring  that  the  patient’s  expressed  choices  are  voluntary.Advance  care  planning  is  a  process  by  which  patients,  with  facilitation  by  a  trained  professional,  clarifies  their  current  health  state,  goals,  and  objectives.A  living  will  is  any  document  where  the  patient  anticipates  a  specific  set  of  medical  circumstances  and  requests  or  refuses  specific  types  of  treatment  under  each  of  these  medical  circumstances.A  health  care  proxy  form  allows  a  patient  to  name  a  surrogate  decision-maker  in  the  event  they  become  unable  to  make  medical  decisions  for  themselves.In  shared  decision-making,  clinicians  are  considered  the  experts  on  prognosis/treatment  options,  whereas  the  patient/family  is  considered  the  expert  on  the  patient’s  values.Palliative  care  is  a  multidisciplinary,  patient-centered  approach  to  care  that  focuses  on  (a)  assessing  and  treating  symptoms;  (b)  providing  psychological  and  spiritual  support  to  patients  and  families;  (c)  facilitating  treatments  that  are  better  aligned  with  patients’  values  by  ensuring  skillful,  proactive,  and  compassionate  communication  between  the  clinical  team  and  the  patients/families.Most  patients  die  in  the  ICU  after  the  withdrawal  or  withholding  of  some  life-sustaining  treatments.The  withdrawal  of  life-sustaining  treatments  should  be  considered  a  clinical  procedure  that  requires  expertise,  careful  preparation,  appropriate  documentation,  and  ongoing  evaluation.